摘要
目的研究尿液β2微球蛋白(β2-MG)对DR的预测价值方法选取2006年7月至2009年9月间在天津医科大学代谢病医院住院的T2DM患者2321例,根据有无DR分为糖尿病不伴视网膜病变组(T2DM,n=1276)和DR组(n=1045),检测各组临床特征和生化指标。采用前瞻性队列研究的方法,于2009年选取386例T2DM患者,根据基线尿β2-MG的中位数水平分为低尿β2-MG组202例和高尿β2-MG组184例。随访3~6年,多元Logistic回归分析分析DR发生的危险因素。应用Kaplan-Meier生存曲线及COX生存分析研究尿β2-MG与DR的相关性。结果 (1)在横向性研究中,年龄、HbA_1c和尿β2-MG是DR的独立危险因素(OR=1.070、1.900、2.846,P<0.05)。(2)另选取386例患者进行的前瞻性随访研究显示,年龄、吸烟史、SBP、BUN、FIns、HbA_1c、尿β2-MG、24h尿微量白蛋白(UMalb)是DR发生的危险因素。多因素COX回归分析显示,尿β2-MG(RR5.501,95%CI5.28,6.88,P=0.017)、24 hUMalb(RR1.046,95%CI1.017,2.046,P=0.026)是DR发生的独立危险因素。Kaplan-Meier生存曲线显示,高尿β2-MG组DR进展快于低尿β2-MG组(P<0.05)。结论尿β2-MG是DR发生的独立危险因素,早期筛查对发现DR有重要意义。
Objective To investigate the predictive value of urinary β2 microglobulin（β2-MG）in type2 diabetic retinopathy（DR）. Methods A total of 2321 hospitalized patients with type 2 diabetes mellitus（T2DM）in the Metabolic Disease Hospital of Tianjin Medical University were enrolled in this study from July 2006 to September 2009,and divided into two groups according to the diagnosis of DR：diabetes without retinopathy group（T2DM,n=1276）and diabetic retinopathy group（DR,n=1045）.The clinical features and biochemical indexes were detected in each group.Using aprospective cohort design,a total of 386 patients with T2DM and without DR were collected in 2009.All these 386 patients were divided into two groups according to the median level of baseline urinary β2-MG：low urinary β2-MG group（n=202）and high urinal β2-MG group（n=184）.All of them were followed up for 3 to 6 years.Multiple logistic regression analysis was used to analyze the risk factors for DR.Kaplan-Meier survival curve and COX survival analysis were applied to evaluate the correlation between urinary OX survival an Results（1）In the cross-sectional study,age,HbA1c and urinary s-sectional study,X survival analysis we（OR=1.070,1.900,2.846,P〈0.05）.（2）Prospective follow-up study of 386 patients showed that age,smoking history,SBP,BUN,FIns,HbA1c,urinary a nitrogh urinary albumin（UMalb）were the risk factors for DR.Multivariate COXregression analysis revealed that urinary β2-MG.（RR5.501,95% CI 5.28,6.88,P=0.017）,24 hmicroalbuminuria（RR1.046,95% CI 1.017,2.046,P=0.026）were independent risk factors for DR.Using the Kaplan-Meier survival curve,we found that the progression of DR was faster in high urinaryβinarystent than in control group（P〈0.05）. Conclusion Urinary β2-MG is an independent risk factor for DR,and early screening of urinary β2-MG level is important in the diagnosis of DR.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2018年第3期201-205,共5页
Chinese Journal of Diabetes
基金
天津市科技计划项目(15ZXHLSY00460)
